WDH says da Vinci robot surgeries going well

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Posted Apr. 13, 2013 at 3:15 AM

Posted Apr. 13, 2013 at 3:15 AM

BY ROD DOHERTY

rdoherty@fosters.com

DOVER — The controversy over the use — or need — of robotic surgery in hospitals surfaced again last month when Massachusetts health officials said some surgeons maybe using the devices without enough training.

In the wake of that advisory, the New Hampshire's Board of Medicine told the N.H. Union Leader in story Monday it was expecting to discuss concerns that complications from robot-assisted surgery are on the rise nationally.

Massachusetts health officials last month said some surgeons may also be using robotic devices where a robotic tool is no better than a surgeon's hands. Prostate, gynecological, cardiac, colorectal, head and neck and other procedures are performed with the devices.

“It will be up for discussion, but at this time I don't know if the board would choose to issue a similar advisory here in New Hampshire,” said Kathy Bradley, executive director for the New Hampshire Board of Medicine. In her interview with the Union Leader, Bradley also noted no complaints have been filed with the New Hampshire board, but the Massachusetts review reports complications are increasing.

In Dover, Wentworth-Douglass Hospital introduced robotic assisted surgery in March 2006 following a review by the Hospital's New Technology Research and Assessment Group to assess the costs, benefits and risks for patients.

The machine most commonly cited and in use at WDH, is known as the da Vinci Robot.

In an emailed statement to Foster's Tuesday, Noreen Biehl, Vice President of Community Relations for WDH, recapped the hospital's history and experience with robotic surgery.

“Wentworth-Douglass Hospital (WDH) introduced robotic assisted surgery in March 2006 following a review by the Hospital's New Technology Research and Assessment Group to assess the costs, benefits and risks for patients.

“WDH is proud of our patient safety record with the da Vinci robot and believe robotic surgery has extended the options for our patients and actually created surgical treatments not available before its implementation.”

In an earlier Wall Street Journal story, published in Foster's, related to the safety of robotics, Biehl said the hospital's da Vinci complication rates were below the rates published in two recent gynecological studies. Wentworth-Douglass adopted the robot for the good of patients and still feels it was the right decision, she said.

The price of the machine ranges from $1 million to $2.25 million, depending on the model. In addition, hospitals pay another $140,000 a year for the robot's maintenance and $1,500 to $2,000 per surgery for replacement parts, according The Wall Street Journal.

Regarding the “right decisions” as noted by Biehl, there was some debate among medical staff at the hospital concerning amount of training for use of the robot and the need at WDH. According to the WSJ story that debate continued after da Vinci was put into use.

“The surgeons, anesthesiologists and staff who work in our OR today are truly dedicated and skilled professionals intent on providing the highest quality surgical services. Every surgical patient, regardless of the type of surgery, is informed before surgery of the options for their procedure including both the risks and benefits,” Biehl wrote.

“One of our gynecologists Anne Kalter, MD, a robotic surgeon who has performed hundreds of robotic assisted surgeries and served as the first chairman of the Hospital's Robotic Committee, said all current surgeons using the da Vinci Robotic system today are very proficient and have improved surgical outcomes.

“We have had an ongoing monitoring process since 2006 of all robotic cases,” Dr. Kalter said. “We maintain a very low complication rate that is also lower than national rates. We are also very aware of the issues surrounding patient positioning and resolved these issues in the very beginning of our program.”

Citing another WDH robotic surgeon, Jeffrey Segil, MD, emphasized the advantages of robotic surgery. “We are doing procedures with the robot that could not be done before, repairs we could not do at all with conventional equipment and procedures, and we're doing them safely,” Dr. Segil said.

The administration at WDH is aware of the recent advisory on robot-assisted surgery from the Massachusetts' Quality and Patient Safety Division.

Hospital President Gregory Walker said, “We appreciate the advisory's quality focus and emphasis on providing patients with information on both risks and benefits.”

“Wentworth-Douglass Hospital has only been named in one lawsuit related to robotic surgery and that lawsuit against WDH was dismissed. There was no merit to the plaintiff's claims vs. Wentworth-Douglass Hospital.” Biehl said.

There have been some investigations of robotic injuries at WDH by the Joint Commission, an independent body responsible for hospital accreditation, according to The Wall Street Journal. But, according to Biehl for that story, “ ... the commission came away satisfied with the quality of the hospital's robotic program and required no improvement.” The Joint Commission confirmed at that time it issued no requirement for improvement but declined to otherwise discuss the inquiry.